It is as though someone has drilled peep holes into the walls of emergency rooms, operating rooms and doctors' offices. I can't look away.

Sunday, March 11, 2007

Dr. Doctor

I just read a medblog about how patients and doctors address each other.

I don’t know if it’s where I am from or how I was raised, but there is absolutely no way that I could call a doctor by his or her first name. I cannot even bring myself to call a blogger doctor by his or her blogging name without inserting Dr. in front of it, e.g., Dr. Dinosaur. Mostly, it’s a sign of respect for the person and the profession.

But that’s not the only reason. I don’t want to call my doctor by his first name. To be honest, I don’t even want my doctor to have a first name. I want that person to be a superhero, with no feelings and no faults. That way, there is no possibility of a bad outcome. I’m not being unrealistic, am I?

I don't call my patients by their first names until they say, "call me whatever"

Most of our docs in the ED ask us to call them by their first name in the nurses station, but it is uncomfortable for me, so I usually add the Dr. part in front of their name... (hey, Dr. Sam, I need...)

The docs (all levels) at our local university OB/GYN unit introduce themselves by first name and proceed from there. Personally I like it because L&D (labor and delivery) can be a rather intimidating environment for women and being on a first name basis with the doctor who shows up makes for a more relaxed atmosphere.

On the other side of the coin: I always had a hard time calling patients by their first names, even when they asked me to. Most especially if they were older than I. In fact, I made it a point to have my staff never call a patient (except kids) by their first name unless asked to.

I've discovered empirically that the natural dividing line (the comfort point) seems to be people our own age. Both as a doc and a patient, it's as awkward to call someone younger than me by title and last name as it is to call someone older by their first name.

MA's desire to keep the doctor at arm's length is completely understandable, and quite common. I respect it when patients prefer not to use my first name.

I think the bottom line is flexibility: willingness to start more formal and move from that only when invited to. Certain situations (ED, L&D, etc.) have different customs that work well. Chacun a son goux. ("to each his own.")

The thing is MBA that doctors are just people who have very specialized knowledge and training which they use to help people, sick people. Once doctors were a part of a select few who were educated. Now many people are as well educated as doctors and they too deserve respect for their knowledge. They have doctorates too. In fact more than half the people I know have doctorates, including my husband and daughter. None even bother to use their titles outside of their professional lives. I think the basic rules of courtesy should apply in these situations. If I, at 71, am addressed as J by some medical professional then I expect to reciprocate with their first name. After all they set the tone. The reverse is true too, I use a title if I am given a title. Later the barriers may be lowered as the relationship progresses.That said, MBA, tell us how it works in the legal world. Do your clients call you Medblog, Med for short, or Ms Addict?Regardsjmb

I've had something of a bee in my bonnet about this issue since the day, 20+ years ago, when I went to see a new gynecologist and he walked in, looked through my file, and said, "You're Jane. Okay, would you please lie down and --"

And I interrupted to say, "Now that we've established who I am - and I prefer to be called Ms. M__ - would you be good enough to introduce yourself before you put your fingers in my vagina?"

He was taken aback, which pleased me greatly.

I prefer to call strangers and recent acquaintances by title and last name until invited to do otherwise. And I'd like everyone else to do the same with me.

I have worked with many ED docs that we called them by their first names. Some though, are always Dr.X.

Even though I have called doctors by their 1st name, I was always careful to refer to them as DR.X around the patients or on the phone etc. as it is more respectful and professional.

I have never called any of the private practice Docs by their 1st name, except for one, but he also hung out by the ED a lot and was a real laid back type of guy. Yet, if I speak about him with his staff or in front of patients - I also always refer to him as Dr. X.

I have never called any of my personal doctors by their 1st names. I ran into my PMD somewhere and thoroughly enjoyed the encounter - he's a great guy. Also, I am happy to know they have lives and I truly hope that they are blessed & happy lives. It doesn't faze me in the least to think of them as human as I warm up to them easier if they are personable.

I will call them whatever they want to be called but if I started out more formal than it is difficult to make the switch.

Even Dr. Schwab - he calls himself Sid Schwab - does he want to be more casual on the blogs or does he prefer Dr. Schwab?

As a patient - I don't care - they can call me whatever they are comfortable with.

This is a kind of funny one with me. I'm just starting out with a whole whack of new docs and oddly enough, we don't even address each other by any name at all!

It's just like we sort of jump in and start talking.

I think as I get to know doctors better, I will refer to them (at least to other parties by their first name?) Or maybe not. It might depend on the relationship I have with them and how long I've known them. And who's comfortable with what.

As for what they call me? First name, please. I don't like formalities. If I'm going to try and have any sort of relationship with you use my name without any kind of "title" attached to it. Maybe that's why I kind of like using doctors' first names as well (if they don't mind.) It helps break down some barriers a bit.

I was so shocked as a married-with-child 24-year-old, after moving to a different state, being addressed by the nurse and doctor by my first name. It was insulting, when they'd introduced themselves by their last names and titles (even the nurse), and such informality was not the custom where I'd grown up. However, I accepted their address, but asked for their first names, which they gave but looked startled. Frankly, I'm more comfortable using people's titles, if they give me one as well. It all probably has to do with personal and cultural boundaries.

"They usually call me Medblog. I call them Mr. Client until asked to call them by their first name."

You're lucky. Being an editor for a publishing house, I sometimes get called things that invariably refer to body parts or female dogs.

But you bring up a really good point. I think it's rude for a doc (or anyone) to assume it's okay to call me by my first name. Conversely, I should act in kind. And now I'm feeling really horrible because I called Dr. Schwab by his first name. I did the same thing to #1Dino. What's more pathetic is I thought about what to call them. Geez, did I make the wrong move? My apologies to Dr. Schwab and #1Dino.

Just a follow up to this. I went to see my GP for a physical last week. I addressed her by her first name and referred to my gastro by his first name. We're all around the same age (mid-late 30s.) I don't know if that makes a difference.

She was totally cool with it and so was I.

Maybe we're all really laid back here in Canada? I don't know where the rest of the other posters are from up there.

And during one of my last appointments with her, she called me "My Dear." I don't know. I guess we have a relaxed relationship?

I try to be flexible as, #1 Dino says. But I tend to prefer the more formal in using titles unless the patient is a child or specifically invites me to use first names. I myself address my colleagues as Dr. unless they give me some indication to do otherwise. I find it does irk me if I address someone as Mr. Smith and he responds using my bare first name. It feels like a power play to me, an attempt to put me down. Of course, culture plays a big role. On the East Asian side of my family, only school chums and children are addressed by first name. Everyone else has a title: e. g. "Older Brother," "Chang's mother," "Pastor," etc.